Is the distance enough to eradicate in situ or early invasive subungual melanoma by wide local excision? from the point of view of matrix-to-bone distance for safe inferior surgical margin in Koreans.

摘要

We read with interest a paper published in a recent issue of Dermatology [1], in which Duarte et al. emphasize the necessity of conservative surgical management in nail matrix melanoma in situ. The authors included early invasive melanoma, as well as in situ melanoma, in the indication for conservative surgical management. Since Hutchinson first described subungual melanoma (SUM) in 1886, a radical surgical strategy has been recommended as a dogma for the treatment of SUM [2, 3]. However, recently SUM has often been managed by conservative surgery such as wide local excision (WLE) and grafting, with which good results were achieved [4-6]. Moreover, Moehrle et al. [7] also proved that functional surgery is superior in terms of cure and survival and that the 2 independent poor prognostic factors are melanoma thickness and amputation.